Speaker Request Form for Visiting Laity Please enable JavaScript in your browser to complete this form.Speaker/Presenter Information:A minimum of eight weeks is required to complete the request. Submissions outside of this timeline are not guaranteed to receive clearance. Approved requests will be provided via email correspondence.Name *Title/Occupation: *Diocese of Residence: *Parish: *Parish Phone: *Parish Fax:Parish Address: *Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePastor: *Type of Ministry *(e.g., speaker, musician, support person, etc.)Event Information:Title: *Date(s): *Location: *Audience: *Will the presenter have access to youth or vulnerable adults? If yes, then describe interaction: *YesNoInteraction Description:Host Contact Information (Requester):Name: *Title/Occupation: *Parish/Organization: *Requester Address:Address Line 1CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmail *Phone: *FaxPlease verify that you have completed an extensive internet background check on the proposed speaker to verify that his/her presentations conform to Church teaching on this requested topic: *YesWhat is the purpose of the event at which this person will be speaking? *Has this person spoken or ministered to this audience before? If yes, when was the event and what are the reasons for having he/she return? *Are you aware of any divergence on this speaker’s past from any Church teachings or any people who might find the speaker or his/her content controversial, unorthodox or problematic? If so, please describe… *Important Follow-Up Tasks to Complete After submitting this form, please email the following supporting documents to beata.gando@seattlearch.org: A letter from your Pastor stating knowledge and consent of the proposed invitation. A letter of recommendation from the speaker’s pastor and/or the Arch/bishop or his representative from the Arch/diocese the speaker resides in. A copy of the speaker’s curriculum vitae or other background information, such as printed publications or websites related to the topic on which the person will be speaking. Submit Request